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Premorbid cannabis use is associated with more symptoms and poorer functioning in schizophrenia spectrum disorder

Published online by Cambridge University Press:  18 August 2016

P. A. Ringen ,
R. Nesvåg ,
S. Helle ,
T. V. Lagerberg ,
E. H. Lange ,
E. M. Løberg ,
I. Agartz ,
O. A. Andreassen  and
I. Melle
P. A. Ringen*
Affiliation:
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
R. Nesvåg
Affiliation:
Department of mental disorders, Norwegian Institute of Public Health, Oslo, Norway Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
S. Helle
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
T. V. Lagerberg
Affiliation:
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
E. H. Lange
Affiliation:
NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
E. M. Løberg
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Clinical Psychology, University of Bergen, Bergen, Norway
I. Agartz
Affiliation:
Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
O. A. Andreassen
Affiliation:
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
I. Melle
Affiliation:
Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
*
*Address for correspondence: Dr P. A. Ringen, Division of Mental Health and Addiction, Oslo University Hospital HF, Psychosis Research Unit/TOP, Ullevål Hospital, Building 49, P.O. Box 4956 Nydalen, N-0424, Oslo, Norway. (Email: p.a.ringen@medisin.uio.no)
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Abstract

Background

Cannabis use disorder is associated with an earlier age at onset and a more severe outcome of schizophrenia spectrum disorders. The role of cannabis use before the onset of illness (premorbid cannabis use) has not been fully investigated. We here examined how amount and type of premorbid cannabis use was associated with the later course of illness including current substance use, symptoms and level of functioning in schizophrenia spectrum disorder.

Method

We used a naturalistic sample of patients with DSM-IV schizophrenia spectrum disorders with a comprehensive history of illness and substance use. Data on premorbid substance use was obtained from comprehensive self-report. The relationship to outcome was investigated using regression models that included current substance use and premorbid functioning.

Results

Pre-schizophrenia cannabis use was significantly associated with more severe psychotic symptoms and impaired functioning. Higher levels of premorbid cannabis use were associated with higher levels of current psychotic symptoms. These associations were independent of current substance use and premorbid functioning. Early use of cannabis (age <17 years) was associated with earlier age at onset of psychosis, independently of potential confounders.

Conclusions

Pre-psychosis cannabis use affects illness outcome in schizophrenia spectrum disorders, and is associated with lower age at onset of psychosis. These findings of independent negative effects of premorbid cannabis use in schizophrenia suggest that a limitation of the general use of cannabis may have beneficial health effects.

Keywords

Age at onsetcannabispremorbidpsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 15 , November 2016 , pp. 3127 - 3136
Copyright
Copyright © Cambridge University Press 2016 

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